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Total 326 results found since Jan 2013.

Talon noir: paring can eliminate the need for a biopsy
Introduction Talon noir (black heel or calcaneal petechiae) is a benign condition that appears as an asymmetric brown-black epidermal macule on the heel or elsewhere on the plantar foot. Punctate papillary dermal haemorrhages extend into the subcorneal space following shearing forces in an area of recurrent or sudden trauma.1 These lesions can mimic melanoma and haemorrhagic viral warts, especially in cases where there is no history of trauma. If the diagnosis of talon noir is considered, simple bedside tests can obviate the need for a biopsy to exclude malignant melanoma or unnecessary treatment for a presumed viral wart....
Source: Postgraduate Medical Journal - November 26, 2014 Category: Journals (General) Authors: Googe, A. B., Schulmeier, J. S., Jackson, A. R., Brodell, R. T. Tags: General practice / family medicine, Drugs: cardiovascular system, Pain (neurology), Stroke, Skin cancer, Screening (oncology), Radiology, Dermatology, Surgical diagnostic tests, General surgery, Epidemiology Images in medicine Source Type: research

Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study
Conclusions: Self-rated health provides a simple, integrative patient-centred assessment for evaluation of illness in the context of multiple chronic disease diagnoses. Those registering in general practice in particular men with three or more diseases or those with cardiovascular comorbidities and with poorer self-rated health may warrant further assessment and intervention to improve their physical and subjective health.
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Nahal MavaddatJose ValderasRianne van der LindeKay KhawAnn Kinmonth Source Type: research

Absolute cardiovascular risk and GP decision making in TIA and minor stroke
Conclusion. In patients presenting with transient or minor neurological symptoms, calculation of ACVR did not improve diagnostic accuracy for TIAMS beyond that of age and sex.
Source: Family Practice - November 18, 2014 Category: Primary Care Authors: Clarey, J., Lasserson, D., Levi, C., Parsons, M., Dewey, H., Barber, P. A., Quain, D., McElduff, P., Sales, M., Magin, P. Tags: Epidemiology Source Type: research

Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood p...
Source: BMJ Open - November 11, 2014 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Global health Protocol Source Type: research

Migraine and risk of hemorrhagic stroke: a study based on data from general practice
Conclusion No clear increased risk of ICH or SAH was observed in migraineurs.
Source: The Journal of Headache and Pain - November 11, 2014 Category: Neurology Source Type: research

Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation.
CONCLUSIONS: -In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death, and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with non-valvular AF. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran. PMID: 25359164 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2014 Category: Cardiology Authors: Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, Sheu TC, Mott K, Goulding MR, Houstoun M, MaCurdy TE, Worrall C, Kelman JA Tags: Circulation Source Type: research

Sex differences in stroke prevention in atrial fibrillation in French primary care. Results of the AFIGP (Atrial Fibrillation In General Practice) Database
Conclusions Most AF patients followed by French GPs required stroke prevention according to European guidelines, but many of them did not receive the recommended antithrombotic treatment. Women over 75 were a third less likely to be treated with recommended anticoagulants than men of similar age.
Source: Clinical Research in Cardiology - October 22, 2014 Category: Cardiology Source Type: research

Stroke conference is vital for those seeking to transform care.
Abstract As a GP and senior clinical researcher looking at ways of reducing cardiovascular events in general practice, I see the irreparable and devastating impact of stroke. PMID: 25315561 [PubMed - in process]
Source: Nursing Standard - October 15, 2014 Category: Nursing Authors: Lasserson D Tags: Nurs Stand Source Type: research

Enhanced invitation methods to increase uptake of NHS health checks: study protocol for a randomized controlled trial
DiscussionThe research will provide evidence on whether asking individuals to complete a preliminary questionnaire, by using the QBE, is effective in increasing uptake of Health Checks and whether an incentive alters questionnaire return rates as well as uptake of Health Checks. The trial interventions can be readily translated into routine service delivery if they are shown to be cost-effective.Trial registration: Current Controlled Trials ISRCTN42856343. Date registered: 21.03.2013.
Source: Trials - August 30, 2014 Category: Journals (General) Authors: Alice ForsterCaroline BurgessLisa McDermottAlison WrightHiten DodhiaMark ConnerJane MillerCaroline RudisillVictoria CorneliusMartin Gulliford Source Type: research

The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study
Conclusions Each of the algorithms performed practically as well in the external independent CPRD validation cohorts as they had in the original published QResearch validation cohorts.
Source: BMJ Open - August 28, 2014 Category: Journals (General) Authors: Hippisley-Cox, J., Coupland, C., Brindle, P. Tags: Open access, Epidemiology, General practice / Family practice, Health informatics Research Source Type: research

Gender differences and patterns of cardiovascular risk factors in Type 1 and Type 2 diabetes: a population‐based analysis from a Scottish region
ConclusionsThe study shows gender differences between Type 1 and 2 diabetes that are of clinical significance and require further investigation. Follow‐up of the patients included in the present study should give us much greater understanding of the importance of gender in the development of metabolic abnormalities and diabetes complications.This article is protected by copyright. All rights reserved.
Source: Diabetic Medicine - August 23, 2014 Category: Endocrinology Authors: A. Collier, S. Ghosh, M. Hair, N. Waugh Tags: Research Article Source Type: research

'More adults should be taking statins,' says NICE
Conclusion Despite somewhat hysterical media coverage to the contrary ("millions more to be given statins," according to the Daily Express), nobody will be forced to take statins. If your GP does recommend statins, you should ask them to explain the benefits and risks for you personally of starting statin treatment. You may want to find out more about statins before making up your mind – the NHS Choices Health A-Z information on statins is a good place to start. If you do experience troublesome side effects while taking statins, contact your GP or the doctor in charge of your care. It could be the case that a...
Source: NHS News Feed - July 18, 2014 Category: Consumer Health News Tags: Heart/lungs Medication QA articles Source Type: news

Herpes zoster as a risk factor for stroke and TIA: A retrospective cohort study in the UK
Conclusion: HZ is an independent risk factor for vascular disease in the UK population, particularly for stroke, TIA, and MI in subjects affected before the age of 40 years. In older subjects, better ascertainment of vascular risk factors and earlier intervention may explain the reduction in risk of stroke after HZ infection.
Source: Neurology - July 7, 2014 Category: Neurology Authors: Breuer, J., Pacou, M., Gautier, A., Brown, M. M. Tags: CORRECTED AND REPUBLISHED ARTICLES Source Type: research

EBN resources page
SIGN Apps for iPhone and iPad http://itunes.com/apps/signguidelines, https://play.google.com/store/apps/details?id=com.rootcreative.sign The SIGN app has recently been updated and now contains quick reference guides (QRGs) for:SIGN 136 Management of chronic pain SIGN 135 Management of epithelial ovarian cancer SIGN 134 Treatment of primary breast cancer SIGN 133 Management of hepatitis C The SIGN app has also had a complete re-design and now features:Optimisation for the latest operating systems Re-designed for improved legibility Send pdf button feature Split screen feature (ipad) Prevention of stroke in patients with atr...
Source: Evidence-Based Nursing - June 17, 2014 Category: Nursing Tags: Liver disease, General practice / family medicine, Hepatitis and other GI infections, Drugs: cardiovascular system, Pain (neurology), Stroke, Diet, Pregnancy, Reproductive medicine, Breast cancer, Gynecological cancer, Lung cancer (oncology), Radiotherapy Source Type: research

A transitional care model for low-income older adults does not reduce readmission rates or emergency department visits during care transitions
Commentary on: Ohuabunwa U, Jordan Q, Shah S, et al.. Implementation of a care transitions model for low-income older adults: a high-risk, vulnerable population. J Am Geriatr Soc 2013;61:987–92. Implications for practice and research A relatively simple, low-cost care transition intervention can encourage low-income, predominantly African-American elders to better utilise primary care, posthospital discharge. An adequately powered study is needed in order to enable stronger conclusions to be drawn, particularly regarding the model's impact on hospital re-admission and emergency department (ED) visits. Studies benefit...
Source: Evidence-Based Nursing - June 17, 2014 Category: Nursing Authors: Nadash, P. Tags: Health policy, General practice / family medicine, Care of the older person, Dementia, Stroke, Hypertension, Memory disorders (psychiatry), Health service research, Diabetes, Metabolic disorders Source Type: research